| NPI | 1922312073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011498A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8858) |
| Enumeration Date | 2010-07-31 |
| Last Update Date | 2010-07-31 |